The Good, the Bad, and the VLDL: Decoding Cholesterol

Too much cholesterol in your body and diet can put you at risk for heart disease and other health problems. However, as you’ve probably heard, there are different kinds of cholesterol, and not all of them are bad for you. It may seem complicated, but learning just a few key facts about cholesterol can help you control your risk.

What is Cholesterol?
Cholesterol is a waxy, fatty substance produced naturally in your liver and typically contained in foods derived from animal products (like meat and dairy). In healthy amounts, cholesterol performs vital body functions: it’s used to build cells and to make vitamin D, bile acids, and hormones. The problem is, you can easily have too much. When cholesterol levels are too high, it builds up on the walls of blood vessels to form plaque. These deposits can make it difficult for blood to flow, which deprives your body of oxygen and puts you at risk for heart disease.

How Can I Tell If I Have High Cholesterol?
There are no direct symptoms of high cholesterol; however, physicians can detect it using a special blood test called a lipid panel. Starting at age 20, you should have your cholesterol
tested at least once every five years; more often, if your physician recommends it. In general, you’re more likely to have high cholesterol if you can say “yes” to any of the following risk factors.

• I’m a smoker.
• I’m overweight.
• I don’t eat healthfully.
• I don’t exercise regularly.
• I have high blood pressure.
• I’m diabetic.
• I have a family history of heart disease.

The Cholesterol Code
Cholesterol travels through the blood attached to a protein. This combination of cholesterol (a lipid) and protein is called a lipoprotein. Lipoproteins are either high-density or lowdensity, based on how much protein and fat they contain.

• Low-density lipoproteins (LDL) are “bad” cholesterol. LDL contains mostly fat with only a small amount of protein. It can build up as plaque inside your arteries (atherosclerosis), which can lead to heart disease. If you have high cholesterol, your doctor will want you to lower your LDL.
• High-density lipoproteins (HDL) are “good” cholesterol. HDL contains more protein than fat. It functions as a “sweeper,” clearing out excess cholesterol in your blood and carrying it back to your liver. A high level of HDL can help prevent heart disease.
• Triglycerides are a common type of fat found in your blood. It’s used to store energy, but if levels are too high, and you also have high LDL, they can increase your risk for developing coronary heart disease (CHD).
• Very-lowdensity lipoproteins (VLDL), a precursor to LDL, are the type of lipoprotein containing the most triglycerides. If you’re taking an LDL-lowering medication, you may also need to take a separate medication for VLDL.

How’s My Cholesterol?
The American Heart Association has come up with optimal levels for total cholesterol and for each type of cholesterol. Compare your most recent test to their numbers to find out how you're doing.